AccountId: 011433970860
ContactId: 07ede43d-c84b-4fe8-ba5e-6f853a5f2d63
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 234449 ms
Total Talk Time (AGENT): 100370 ms
Total Talk Time (CUSTOMER): 90969 ms
Interruptions: 2
Overall Sentiment: AGENT=1.5, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/09/07ede43d-c84b-4fe8-ba5e-6f853a5f2d63_20250109T17:03_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hello, hello, sorry, good morning. This is [PII] from Worba Medical Center, and I'm calling to verify the benefits and eligibility for mutual patient.
[AGENT][NEUTRAL] Morning.
[AGENT][NEUTRAL] OK, I can help you with benefits and eligibility and you said your name was [PII]?
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK, [PII], what is your callback number just in case our call gets disconnected?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Uh.
[AGENT][POSITIVE] OK, thank you so much.
[CUSTOMER][NEUTRAL] I I.
[AGENT][NEUTRAL] Thank you, [PII]. And what is the patient's name?
[CUSTOMER][NEUTRAL] It is [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] Thank you and then what is the patient's policy number?
[CUSTOMER][NEUTRAL] 152-635-0.
[AGENT][POSITIVE] OK, let me pull that policy in for us real quick so we can get the eligibility and benefits for you.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][POSITIVE] Alright thank you so much.
[AGENT][POSITIVE] You're very welcome.
[AGENT][NEUTRAL] So I do show that uh [PII] does have an effective date of [PII] and this is just to verify coverage. It's not a guarantee of payment. He has a supplemental insurance policy that is secondary to his primary.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][POSITIVE] The policy helps with
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] Deductible, co-pay, and co-insurance, he has an inpatient benefit amount of $4500 per calendar year and he also has an outpatient benefit amount of $4500 per calendar year.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK, and I just want to confirm if it's still active.
[AGENT][NEUTRAL] Yes, the policy is still active.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And I just wanna ask, this is a supplemental, right?
[AGENT][NEUTRAL] Yes, it's a supplemental insurance, a gap insurance that helps with deductible, co-pay or co-insurance.
[CUSTOMER][POSITIVE] All right, thank you so much. Uh, may I know if what plan is?
[AGENT][NEUTRAL] Yes, it's a Medlink.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Alright, may I look and it's plan you or not?
[AGENT][NEUTRAL] I'm sorry, what did you say?
[CUSTOMER][NEUTRAL] I'm not. It's OK, um.
[CUSTOMER][NEUTRAL] Since I got all the information that I needed for today, uh.
[CUSTOMER][NEUTRAL] I just wanna ask if prior authorization is not required correct.
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] Alright, thank you so much and sorry, can I have your initial of your last name please for my documentation purposes.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Yes, ma'am, it's [PII]
[CUSTOMER][NEUTRAL] And they have an number for this call.
[AGENT][NEUTRAL] Yes, you can use my name, [PII], and today's date.
[CUSTOMER][POSITIVE] Alright, thank you so much you have a great day.
[AGENT][POSITIVE] You have a great day too [PII] and thank you for calling APL.